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Am J Prev Med. 2013 Apr;44(4):325-329. doi: 10.1016/j.amepre.2012.11.032.

Promoting colorectal cancer screening discussion: a randomized controlled trial.

Author information

1
Department of Psychology, Purdue School of Science, Indiana University-Purdue University Indianapolis, Indiana.
2
School of Medicine, Indiana University, Indianapolis, Indiana.
3
School of Nursing, Indiana University, Indianapolis, Indiana.
4
Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas.
5
College of Journalism and Mass Communication, University of Georgia, Athens, Georgia.
6
School of Nursing, Indiana University, Indianapolis, Indiana. Electronic address: srawl@iupui.edu.

Abstract

BACKGROUND:

Provider recommendation is a predictor of colorectal cancer (CRC) screening.

PURPOSE:

To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening.

DESIGN:

Two-group RCT with data collected at baseline and 1 week post-intervention.

SETTING/PARTICIPANTS:

African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics.

INTERVENTION:

Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit.

MAIN OUTCOME MEASURES:

Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012.

RESULTS:

Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05).

CONCLUSIONS:

The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP.

TRIAL REGISTRATION:

This study is registered at www.clinicaltrials.gov NCT00672828.

PMID:
23498096
PMCID:
PMC3601582
DOI:
10.1016/j.amepre.2012.11.032
[Indexed for MEDLINE]
Free PMC Article

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